Alberto Aimo

🫀 Inflammatory cardiomyopathy: new position paper from the Italian Society of Cardiology A new position paper from the Italian Society of Cardiology Working Groups on Cardiomyopathies and Cardiac Magnetic Resonance provides a comprehensive framework for the diagnosis, risk stratification, and management of inflammatory cardiomyopathy (iCMP). 1-s2.0-S0167527326000975-main Inflammatory cardiomyopathy represents the chronic phase of myocarditis, characterised by persistent myocardial inflammation, ventricular dysfunction, and adverse cardiac remodelling. It may lead to dilated cardiomyopathy, heart failure, and ventricular arrhythmias, highlighting the need for early recognition and targeted management. 🔬 Key messages from the position paper 📍 Multimodality diagnosis is essential Cardiac magnetic resonance (CMR) plays a central role in detecting inflammation and fibrosis, while endomyocardial biopsy remains critical to identify the underlying aetiology and guide therapy. 🧬 Genetics matters A “two-hit” model—genetic susceptibility combined with environmental triggers such as viral infection—may explain why some patients progress from myocarditis to chronic cardiomyopathy. 💊 Targeted therapy based on aetiology Management includes guideline-directed heart failure therapy, while immunosuppressive treatment may benefit biopsy-proven virus-negative inflammatory cardiomyopathy. ⚡ Arrhythmic risk and long-term follow-up Fibrosis detected by CMR and arrhythmic burden are key prognostic markers, and lifelong follow-up is recommended due to the risk of disease progression or recurrent inflammatory “hot phases.” 📊 This document highlights the importance of integrating imaging, genetics, and biopsy findings to move toward a more mechanism-based and personalised approach in inflammatory cardiomyopathy. #Cardiology #Myocarditis #InflammatoryCardiomyopathy #CardiacMRI #HeartFailure #Arrhythmia #PrecisionMedicine #CardioResearch #ESC #CardioTwitter doi.org/10.1016/j.ijca…

Clinical Guidelines as a Continuous Work in Progress: Moving at the Speed of Science ahajrnls.org/4bnAEWB

The first time you start a research lab, there’s no manual. So I made one. A practical toolkit for postdocs and early-career faculty launching their first lab: hiring, startup planning, collaborations, and building a sustainable research program. zenodo.org/records/188835…

🔬 Great collaboration across leading amyloidosis centers in Europe and the US 🇮🇹🇬🇧🇺🇸 📄 Read it here: pubs.acs.org/doi/pdf/10.102… #Proteomics #CardiacAmyloidosis #MassSpectrometry #PrecisionMedicine #Amyloidosis

FDA authorizes resumption of Intellia’s heart‑disease gene therapy trial after a safety pause. Last year, the FDA paused Intellia's two trials of the ​gene-editing treatment after a patient in the heart disease study was ​hospitalized with severe liver complications and later died. Monday's decision allows for resumption for the trial in cardiomyopathy patients. reuters.com/business/healt…

WikiDoc.org now handles about a billion page requests per year ! 20 years >110,000 chapters created by thousands of MDs Millions of edits Free Collaborative authoring International faculty Updated continuously based on content from leading journals

An artificial-intelligence system uses clinical data, genetic information and literature searches to suggest diagnoses and provides the underlying reasoning go.nature.com/4cCjDKq

Heart failure endpoints in Food and Drug Administration pivotal trials The evolving landscape of HF management may lead to larger sample size requirements to detect smaller incremental benefits given the burgeoning standard of care. While this may be addressed through pragmatic cardiovascular outcome trial designs, the field has also embraced symptomatic and functional endpoints with potentially smaller sample size requirements. #Cardiology #MedTwitter #CardioTwitter #HeartHealth #Healthcare @mvaduganathan @hvanspall @gcfmd @SJGreene_md @DrMarthaGulati @hfcollaboratory @AndrewJSauer @Hragy @ShelleyZieroth @AnastasiaSMihai @biljana_parapid academic.oup.com/eurheartj/adva…

Important paper by the NAC group AF, atrial myopathy, stroke/TIA are special in ATTR/cardiac amyloidosis. You need to dive deep into the paper. Lots of data. Thought provoking to go beyond AF itself. Although not super clear, likely the majority were not on ATTR-CM directed therapy. Whether this makes a difference or not is unclear, since the investigators used baseline LA function. jacc.org/doi/10.1016/j.… #CardioTwitter

🔍 Terapia de resincronización cardiaca, remodelado y resultados en pacientes con Amiloidosis Cardiaca por Transtiretina (ATTR-CM) Alberto Aimo @albertoaimo_md Lee el artículo completo aquí: cardioteca.com/blog-amiloidos… 🔹 La TRC mejora la sincronización eléctrica y la FEVI en pacientes con ATTR-CM 🔹 La evaluación temprana tras el implante es clave para estratificar el riesgo 🔹 La TRC no sustituye el tratamiento modificador de la enfermedad, pero es fundamental en un enfoque integral @fdefrutossemi

Aficamten is now approved in the EU as well. An important addition for patients with HCM. #CardioTwitter finance.yahoo.com/news/cytokinet…

Systemic Manifestations and Mortality Risk in Transthyretin V142I Variant Carriers: A Million Veteran Program Analysis These findings highlight the systemic manifestations of variant transthyretin amyloidosis associated with the TTR V142I variant and underscore the need for increased awareness and earlier diagnostic efforts in high-risk populations. #Cardiology #MedTwitter #CardioTwitter #HeartHealth #Healthcare @JACCJournals @ACCinTouch @MasriAhmadMD @ESC_Journals @escardio jacc.org/doi/10.1016/j.…

Redefining optimal medical therapy for heart failure in amyloid transt... sciencedirect.com/science/articl… @chemachir @JuliaSellerm @IcyfaSemi @markinho_gc @SABOURETCardio @Sabater71 @sergi_yun

Soluble ST2 drives fulminant myocarditis progression via the IGF2R–YY1 mitochondrial axis. Read more the @EHJ at doi.org/10.1093/eurhea… #MyocarditisResearch #Cardiology #HeartHealth #MitochondrialFunction #IGF2R #YY1 @ESCardio @ESC_Journals

Changing from high-sensitivity cardiac troponin I to T assay doubled myocardial injury detection and admissions, without improving 1-year cardiovascular outcomes in suspected #AcuteCoronarySyndrome. ja.ma/4a8IbI3

🧠 AI in Hospitals: It’s Not Going Where It’s Needed Most A new national analysis of 3,500+ US hospitals shows something uncomfortable: - AI adoption is clustered. - And it’s often lowest where healthcare needs are highest. Nearly half of hospitals report using AI-based predictive models. But hospitals in provider shortage areas are significantly less likely to implement them. This isn’t an innovation gap. It’s an infrastructure gap. The strongest predictor of AI implementation wasn’t size, prestige, or profit status. It was interoperability. Hospitals with better data exchange capabilities are far more likely to deploy AI. Let that sink in. AI doesn’t start with algorithms. It starts with clean data, governance, integration, and system readiness. Even more concerning: Many hospitals reported limited evaluation of: - Model accuracy - Bias - Ongoing monitoring Adoption ≠ maturity. We may be building an ecosystem where: Technology scales fastest where systems are strongest And lags where the need is greatest If AI truly becomes a quality multiplier, uneven deployment risks becoming a disparity multiplier. The real question isn’t: “Who is using AI?” It’s: 👉 Who is being left behind? And are we designing AI systems to reduce inequity — or simply to reward readiness?

Excellent paper here by Dr. Sheikh and Dr. Fontana et al. placing CMR ECV within context and clinical usefulness. It is also a reminder that ATTR-CM is a fatal disease. Over 2.8 years, 40% died (enrolled over 13 years). jacc.org/doi/10.1016/j.… #CardioTwitter

#Amiloidosi AL: tra complessità clinica, tempismo e scelte decisive. Il consensus SIC/ANMCO di Aimo et al. mette ordine fra le incertezze giornaledicardiologia.it/archivio/4636/…

New large population-based study provides updated estimation about the prevalence and phenotypic distribution of heart failure in Portugal doi.org/10.1093/eurhea… #heartfailure #cardiotwitter @ESC_Journals @escardio

After the two recent meta-analyses published in The Lancet and NEJM, one could argue that the case is settled: following myocardial infarction, beta-blockers should be prescribed to patients with an LVEF <40%, may be considered in those with an LVEF of 40–49%, and in patients with an LVEF ≥50% only if there are other indications, such as hypertension, atrial fibrillation, or heart failure. The guidelines are partially misaligned with the emerging evidence and will most likely be updated in the near future.